SANDRA JACKSON
Individual Provider (NPI-1)
Active
Home Health Aide
Provider Information
- NPI Number
1003536707- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 4513 PINE KNOLL DR, SHREVEPORT, LA, 711072605
- Phone
- (318) 617-8095
Specialties & Taxonomies
Home Health Aide
Primary
All Addresses
MAILING
4513 PINE KNOLL DR
SHREVEPORT, LA, 711072605